DLeague Registration Form

D-League Basketball Registration Form

TRY BOYS STADIUM- 501 Ryrie St East Geelong
Player Name

First NameLast Name
Player Birth Date

DayMonthYear
Parent Contact Name

First NameLast Name
Parent Contact Phone
Format: (000) 000-0000.
Parent Contact E-mail
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What session time will you attending? **Please NOTE- $20 D-League Registration per term for all $10 sessions**
Do YOU have a Medical Condition that may be impacted by attending our sessions?
I acknowledge that I am responsible for the medical care of myself and/or my child/attendee, including providing any required medications. I understand and agree that D-League is not responsible or liable for any medical events or injuries that occur before, during, or after participation in D-League programs.
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D-League Basketball Registration Form